Is Abilify (Aripiprazole) used for anxiety?

From the Guidelines

Abilify (aripiprazole) is not typically recommended as a first-line treatment for anxiety.

Primary Indications

While it may be used off-label for anxiety disorders, its primary indication is for schizophrenia, bipolar disorder, and major depressive disorder.

Dosage and Usage

If prescribed for anxiety, the usual dose is 5-15 mg per day, and it's often used in conjunction with other medications.

Alternative Treatments

However, due to potential side effects and limited evidence for its effectiveness in anxiety, it's essential to exercise caution and consider alternative treatments, such as:

• Selective serotonin reuptake inhibitors (SSRIs)
• Benzodiazepines, under the guidance of a qualified healthcare professional 1.

Key Considerations

Some key points to consider when using Abilify for anxiety include:

• Limited evidence: There is limited evidence to support the use of Abilify for anxiety disorders, and it is not approved by the FDA for this indication.
• Off-label use: Abilify may be used off-label for anxiety disorders, but this should be done with caution and under the guidance of a qualified healthcare professional.
• Alternative treatments: Alternative treatments, such as SSRIs and benzodiazepines, may be more effective and have a stronger evidence base for the treatment of anxiety disorders.
• Potential side effects: Abilify can cause potential side effects, such as headache, agitation, anxiety, insomnia, dizziness, and drowsiness, which should be carefully monitored and managed by a healthcare professional 1.

From the FDA Drug Label

Advise the patient to read the FDA-approved patient labeling (Medication Guide) Discuss the following issues with patients prescribed aripiprazole tablets: Clinical Worsening of Depression and Suicide Risk Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down.

The FDA drug label does not answer the question of whether Abilify (Aripiprazole) is used for anxiety, it only mentions that patients should be alert to the emergence of anxiety as a potential symptom. 2

From the Research

Use of Abilify (Aripiprazole) for Anxiety

• Aripiprazole, also known as Abilify, has been studied for its potential use in treating anxiety disorders 3, 4, 5.
• Research suggests that aripiprazole may be effective in reducing anxiety symptoms, particularly in patients who have not responded to traditional treatments such as selective serotonin reuptake inhibitors (SSRIs) 3, 5.
• A study published in the Journal of Affective Disorders found that aripiprazole augmentation in patients with anxiety disorders was likely as effective as other atypical antipsychotic drugs 3.
• Another study published in CNS Drugs noted that aripiprazole has a unique mechanism of action and a relatively low adverse effect burden, making it an interesting potential treatment for depressive and anxiety disorders 4.
• A small open-label study found that 80% of patients with residual anxiety symptoms who were taking SSRIs had a greater than 50% reduction in symptoms after adding aripiprazole to their treatment regimen 5.

Mechanism of Action and Efficacy

• Aripiprazole's mechanism of action involves partial agonism of dopamine D2 and serotonin 5-HT1A receptors, as well as antagonism of serotonin 5-HT2A receptors 4, 6.
• This unique mechanism of action may contribute to its potential efficacy in treating anxiety disorders, as well as its relatively low risk of adverse effects such as weight gain and metabolic disturbances 4, 6.
• Studies have shown that aripiprazole is effective in reducing symptoms of mania and depression, and may also be effective in reducing anxiety symptoms 3, 4, 6, 7, 5.

Limitations and Future Research

• While the available evidence suggests that aripiprazole may be effective in treating anxiety disorders, more rigorous double-blind studies are needed to confirm and elucidate its potential role in these conditions 3, 4, 5.
• Further research is also needed to fully understand the mechanism of action of aripiprazole and its potential benefits and risks in treating anxiety disorders 4, 6.